title: Absorption of macronutrients and nitrogen balance in children with dysentery fed an amylase-treated energy-dense porridge.
abstract: The aim of this study was to determine the absorption of macronutrients and energy from an energy-dense diet liquefied with amylase from germinated wheat (ARF) in children suffering from acute dysentery. Thirty male children aged 6-35 months presenting with acute dysentery were randomly assigned to receive either an ARF-treated porridge or a standard porridge liquefied with water to make its consistency similar to the ARF porridge. After 24-h stabilization a 72-h metabolic balance was performed. Sixteen children received an ARF-treated porridge and 14 received a standard porridge liquefied with water. The mean +/- SD coefficients of absorption (%) of carbohydrate, fat, protein and energy (ARF porridge vs regular porridge) were 81.4 +/- 11 vs 86.9 +/- 7, 86.1 +/- 10 vs 82.8 +/- 15, 57.3 +/- 12 vs 48.4 +/- 24 and 81.4 +/- 9 vs 83.1 +/- 8, respectively. The stool loss of carbohydrate, protein, fat and energy was similar in the two groups. The net absorption of energy was substantially greater in the ARF-fed than regular porridge-fed children (by 28%, p = 0.01). The nitrogen balance was 6.9 +/- 3.4 mg kg(-1) d(-1) in the ARF porridge group and 1.1 +/- 6.7 mg kg(-1) d(-1) in the regular porridge group (p = 0.01). These results show that, despite being hyperosmolar, an amylase-treated liquefied energy-dense porridge is absorbed as well as a regular porridge by malnourished children with severe dysentery. Consequently, its use substantially increased the absorption of a net amount of macronutrients and resulted in a better nitrogen balance. These results further support this innovative approach of feeding sick children in developing countries.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh, Clinical Sciences Division, Dhaka.
authors.forename: M M
authors.initials: MM
authors.lastname: Rahman
authors.forename: D
authors.initials: D
authors.lastname: Mahalanabis
authors.forename: M
authors.initials: M
authors.lastname: Ali
authors.forename: R N
authors.initials: RN
authors.lastname: Mazumder
authors.forename: M A
authors.initials: MA
authors.lastname: Wahed
authors.forename: G J
authors.initials: GJ
authors.lastname: Fuchs
mesh_terms: D000208:Acute Disease; D000681:Amylases / Q000008:administration & dosage*; D018554:Avena; D015362:Child Nutrition Disorders / Q000178:diet therapy* / Q000209:etiology; D002675:Child, Preschool; D015623:Diet, Macrobiotic; D004040:Dietary Carbohydrates / Q000493:pharmacokinetics*; D004041:Dietary Fats / Q000493:pharmacokinetics*; D004044:Dietary Proteins / Q000493:pharmacokinetics*; D004405:Dysentery, Bacillary / Q000175:diagnosis / Q000178:diet therapy*; D004734:Energy Metabolism; D005527:Food, Fortified; D006801:Humans; D007194:India; D007223:Infant; D007228:Infant Nutrition Disorders / Q000178:diet therapy* / Q000209:etiology; D007408:Intestinal Absorption; D008297:Male; D009584:Nitrogen / Q000493:pharmacokinetics; D016896:Treatment Outcome
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D000681:Amylases; D009584:Nitrogen